Obesity Flashcards
Pharmacological Management of Obesity
Orlistat 120mg PO TDS - Reduces fat absorption in intestine. SE Malodorous stool, abdominal bloating, pain, faecal ooze. SE can be controlled with maintaining low fat diet.
Phentermine 15/30/40mg PO OD - Course <=12 weeks, Increase metabolism - SE - Tachycardia, hypertension, insomnia, dry mouth, constipation, nervousness. Cost $100/month
Contrave (Buproprion/Naltrexone 8/90mg ii PO BD - Reduces food craving. SE Constipation, diarrhoea, dizziness, dry mouth, headache, insomnia, nausea, vomiting. Cost $245/month
Topiramate
Varying doses PO OD, Suppresses hunger. SE Paraesthesia of hands/arms /feet/face dizziness, insomnia, constipation, dry mouth, tachycardia, suicidal thoughts.
Semaglutide & Liraglutide - GLP1ia - Incretin mimetic. Slows gastrice emptying. Weekly semaglutide or daily liraglutide injection. SE - Nausea, GI, anorexia, GORD, decreased appetite, headache. Cost $387/month for liraglutide. If no response in 3 months of use, cease.N
Non-pharmacological management of obesity
VLED (Very low energy diet
- Replacing all meals with specific meal replacement formula. High protein and low carbohydrate. Induces fat burning and mild ketosis -> Hunger suppression and promotion of satiety.
- < 800 cal/day.
- Use if BMI > 30.
- Use generally for 8-12 weeks.
Contraindications
- Pregnant, lactating, age < 18, age > 65, recent ACS,
